This showed that consumption of chewable tobacco is not confined to only lower socio-economic group.

Non-governmental organisations working to improve the lives of bidi makers in rural areas have noted that younger women involved in the work chewed tobacco to suppress hunger.

Chewable tobacco contains betel nut and lime, and often even narcotic and other banned and unspecified addictive substances, said Dr. Hussain.

The Indian Dental Association launched a tobacco-free campaign last year in dental colleges across the city as dentists are among the first to identify possibility of oral cancer in a patient, said V. Rangarajan, secretary of the association’s Chennai branch.

The impact of tobacco on a person’s health would be easy to identify when he or she comes for a dental check up, he explained. “Tobacco use begins with youngsters. We are the first to detect oral cancers. When we check a person’s mouth we know that the person is using tobacco,” Dr. Rangarajan said.

Not only are oral cancers painful and result in deformity but ulceration or cancerous growth in the oral cavity affects food intake.

Sometimes food leaks out of the cheek and as the disease progresses it can spread to other parts of the face and neck.

Despite the seriousness of the problem, doctors find that a majority of patients come when the disease is in an advanced, incurable stage.

And, most of the time doctors can only provide psychological support as their health is severely compromised by then, said Dr. Hussain.